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Short Term / Long Term Disability - Health Benefits
Mar 24, 2005

First Off - Thanks for all the great info in the Ask the Experts section.

I have a few questions. I am 39, currently employeed and have been with the same company for 13 years. I carry medical beneifits through my employer as well as STD and LTD (employee paid/own occupation 1 yr, any occupation after that). On the advise of a close friend, I purchased a separate LTD policy 2 yrs ago on my own, which is Own Occupation for the life of the policy.

I am HIV+, have been diagnosed with depression, and will be starting Meds in about 3 weeks. I have the support of my medical team if I want to go on STD, and if need be, we will explore if LTD is necessary. Now the questions.

1. What are the precedures for informing my employer I am going out on disability. Am I required to give them any notice, or do I just call in a claim with the provider, wait the 14 day elimination period, send in the forms to the insurer and then wait for a check?

2. Do health benefits continue at the same rate I am paying now, as a payroll deduction, while I am on disability or do I apply for COBRA?

3. If I am to go on LTD, I will file the claim with my personal LTD policy, when do I need to get that paperwork started?

Thanks again for all the great info your site provides. It has helped me on many occasions.

Keep up the great work.

Response from Ms. Franzoi

1. Under FMLA (assumes your company has 50 or more employees), you will have to notify your employer of your need for a leave in writing or verbally at least 30 days before a forseeable leave, provide a medical certification of your serious health condition, etc. You should contact your HR Department for the specifics on what is required to take a medical leave of absence. If you are on a medical leave of absence and have coverage under a company-sponsored STD plan, your Benefits or HR Department will work with you to file for your STD benefits under the plan.

2. What happens with your health benefits depends on your company's policy. Check your health plan summary plan description (SPD). The SPD should advise you what happens with your health care coverage when you are on a leave - paid or unpaid , when coverage ends and if so, when COBRA is extended. If you qualify for COBRA, the company will send you a COBRA notice advising you of your rights, the cost for coverage, how to apply, etc.

3. If you are on STD and then move on to LTD, I would suggest applying for LTD benefits 30-45 days prior to the date you anticipate benefits commencing. For example, if your policy has a 90-day waiting period, I would apply for benefits after 60 days of disability.

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